Risk Factors For Suicidal Events Found Among Adolescents With Treatment-Resistant Depression

Main Category: Depression
Also Included In: Psychology / Psychiatry
Article Date: 19 Feb 2009 - 4:00 PDT

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Family conflict, drug or alcohol use and pre-existing suicidal thoughts were the strongest predictors of suicidal events among adolescents whose depression treatment was changed after a lack of response to a previous medication.

The findings were reported today in the article "Predictors of Spontaneous and Systematically Assessed Suicidal Adverse Events in the Treatment of SSRI-Resistant Depression in Adolescents (TORDIA) Study," at AJP in Advance, the online advance edition of The American Journal of Psychiatry (AJP), the official journal of the American Psychiatric Association.

In the study, 334 adolescent patients who had not responded to a selective serotonin reuptake inhibitor (SSRI) were switched to a different SSRI or to venlafaxine, with or without cognitive-behavioral therapy. Forty-eight patients experienced a suicidal event-suicidal ideation (new or worsening), a suicidal threat or a suicide attempt. The median time from a suicidal threat to a suicidal event was three weeks. In the AJP article, lead author David Brent, M.D., and colleagues recommend careful monitoring of more severely depressed adolescent patients who have high levels of suicidal thoughts or family conflict.

Treatments that target family conflict and emotion regulation early may help reduce suicidal events. Likewise, since the predictors of suicidal events also predict poor treatment response, targeting family conflict, suicidal ideation and drug use may hasten response and help to reduce the incidence of these events. TORDIA is sponsored by the National Institute of Mental Health. Any other funding the authors may have received is disclosed in the article itself.

The American Journal of Psychiatry is the official journal of the American Psychiatric Association. Statements in this press release or the articles in the Journal are not official policy statements of the American Psychiatric Association.

About the American Psychiatric Association

The American Psychiatric Association is a national medical specialty society whose more than 38,000 physician members specialize in diagnosis, treatment, prevention and research of mental illnesses, including substance use disorders. Visit the APA at http://www.psych.org and http://www.HealthyMinds.org.

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